Presentation
Fall from 10 feet. Landed on back. Injury to right wrist.
Patient Data
Normal chest radiograph.
Large region of splenic hypoattenutation in the cranial portion of the spleen. Normal enhancement anteriorly and inferiorly. At the junction between normal spleen and non-enhancing spleen, there is a region of dense contrast. This represents a contained vascular injury (as opposed to active splenic hemorrhage), a pseudoaneurysm.
Case Discussion
A triple-phase CT was performed at an external institution. Three phases are not required in the assessment of pediatric trauma. A split-bolus study will give you the same information and is essentially the same as the third phase of this study.
In this case, isolated splenic trauma with a splenic laceration and active hemorrhage with contrast concentration on the portal venous phase study.
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